Perinatal microbial exposure may influence aortic intima-media thickness in early infancy

Kate McCloskey; Peter Vuillermin; John B Carlin; Michael Cheung; Michael R Skilton; Mimi Lk Tang; Katie Allen; Gwendolyn L Gilbert; Sarath Ranganathan; Fiona Collier; Terence Dwyer; Anne-Louise Ponsonby; David Burgner; BIS Investigator Group

doi:10.1093/ije/dyw042

Perinatal microbial exposure may influence aortic intima-media thickness in early infancy

Int J Epidemiol. 2017 Feb 1;46(1):209-218. doi: 10.1093/ije/dyw042.

Authors

Kate McCloskey^{1

2

3}, Peter Vuillermin^{1

2

4}, John B Carlin^{1

3}, Michael Cheung^{1

3}, Michael R Skilton⁵, Mimi Lk Tang^{1

3}, Katie Allen^{1

3}, Gwendolyn L Gilbert⁶, Sarath Ranganathan^{1

3}, Fiona Collier^{2

4}, Terence Dwyer^{1

3}, Anne-Louise Ponsonby^{1

3}, David Burgner^{1

3

7}; BIS Investigator Group

Affiliations

¹ Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.
² Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.
³ Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
⁴ Department of Medicine, Deakin University, Waurn Ponds, VIC, Australia.
⁵ Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders.
⁶ Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, WA, Australia.
⁷ Department of Paediatrics, Monash University, Melbourne, VIC, Australia.

PMID: 27059546
DOI: 10.1093/ije/dyw042

Abstract

Background: The maternal and infant microbiome may influence infant cardiovascular risk through immune programming. The maternal vagino-enteric microbiome is often sampled for group B streptococcus (GBS) colonization during pregnancy. Our aim was to investigate the association between maternal GBS colonization, intrapartum antibiotics, antenatal pet exposure and infant aortic intima-media thickness (aIMT), an intermediate vascular phenotype, and whether this association varied by mode of delivery.

Methods: The Barwon Infant Study is a population-derived pre-birth cohort. Perinatal data were collected on participants. Women were tested for vagino-enteric group B streptococcus (GBS) colonization during third trimester. Six-week infant aIMT was measured by trans-abdominal ultrasound. Adjustment for confounders included maternal age, pre-pregnancy body mass index (BMI), smoking, socioeconomic status, gestational diabetes, length of gestation, infant sex, birthweight and aortic internal diameter.

Results: Data were available on 835 mother-infant pairs. Of these, 574 (69%) women delivered vaginally; of those, 129 (22%) were GBS-colonized; and of these women, 111 (86%) received prophylactic intrapartum antibiotics. An association between maternal GBS colonization and infant aIMT was observed among those delivered vaginally (β = 19.5 µm, 95% CI 9.5, 29.4; P < 0.0001) but not by Caesarean section ( P for interaction = 0.02). A similar pattern was seen for intrapartum antibiotics. There was a negative association between antenatal pet exposure and aIMT observed in those delivered vaginally.

Conclusion: Maternal GBS colonization and intrapartum antibiotics were associated with increased infant aIMT in those delivered vaginally, whereas antenatal pet exposure was associated with decreased aIMT. These data suggest that differences in early life microbial experience may contribute to an increased cardiovascular risk.

Keywords: cardiovascular; infant; intima-media thickness; maternal; microbiome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Animals
Anti-Bacterial Agents / administration & dosage*
Aorta / diagnostic imaging*
Australia
Cardiovascular Diseases / diagnostic imaging
Cardiovascular Diseases / epidemiology
Cohort Studies
Environmental Exposure / adverse effects*
Female
Humans
Infant
Linear Models
Logistic Models
Male
Pets
Pregnancy
Pregnancy Complications, Infectious / drug therapy
Risk Factors
Streptococcal Infections / drug therapy
Streptococcus agalactiae / isolation & purification*
Tunica Media / diagnostic imaging*
Ultrasonography

Substances

Anti-Bacterial Agents